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HomeMy WebLinkAbout466828 AECOM - INSURANCE CERTIFICATE—, ® A� Rb CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/07/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh Risk & Insurance Services CA License #0437153 777 South Figueroa Street Los Angeles, CA 90017 Attn: LosAngeles.CertRequest@Marsh.Com 06510 -PROJ-GAUE-17-18 FortCo CO 04 2019 CONTACT NAME: FAx PHONE t; ac No: - E-MAADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Zurich American Insurance Company 16535 INSURED AECOM AECOM Technical Services, Inc. INSURER B : NIA N/A INSURER C : Illinois Union Insurance Co 27960 INSURER D : SEE ACORD 101 EDAW, INC. 240 E. Mountain Avenue Fort Collins, CO 80524 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: LOS-002106526-84 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY GLO596589109 04/01/2017 04/01/2018 EACH OCCURRENCE $DAMAGETO 1,000,000 CLAIMS -MADE IT] OCCUR TED PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PE� u LOG OTHER: A AUTOMOBILE LIABILITY BAP 5965893 09 04/01/2017 04/01/2018 Ee aBcideDtSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y /N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NJ (Mandatory in NH) N/A SEE ACORD 101 01/01/2019 X STATUTE EORH E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE -POLICY LIMIT $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below C ARCHITECTS & ENG. EON G21654693 04/01/2017 04/01/2018 Per Claim/Agg $1,000,000 PROFESSIONAL LIAB. ""CLAIMS MADE"" Defense Included DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: PROJECT #41`002.01 I GARDENS ON SPRING CREEK CHILDREN'S GARDEN THIS CERTIFICATE IS ISSUED AS RESPECTS LIABILITY ARISING OUT OF THE WORK PERFORMED BY OR ON BEHALF OF THE NAMED INSURED. SEE ATTACHED WAIVER OF SUBROGATION ENDORSEMENT. lh a:i �111�L'll.? CITY OF FORT COLLINS ATTN: JAMES B. O'NEILL II DIRECTOR OF PURCHASING RISK MGMT. P.O. BOX 580 FORT COLLINS, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services James L. Vogel—�Z�"r�r� V lUStf-LUTb AL,UKU UUKYUKA I IUIY. iill rl91lL`S FU5tirvCu. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 06510 LOC #: Los Angeles ACO DR L ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh Risk & Insurance Services AECOM AECOM Technical Services, Inc. EDAW, INC. POLICY NUMBER 240 E. Mountain Avenue Fort Collins, CO 80524 CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation/Employer Liability cunt. Policy Number Insurer WC 014629525 American Home Assurance Company - NAIC #19380 WC 014629526 The Insurance Company of the State of Pennsylvania - NAIC #19429 WC 014629527 The Insurance Company of the State of Pennsylvania - NAIC #19429 WC 014629528 The Insurance Company of the State of Pennsylvania - NAIC #19429 WC 014629529 The Insurance Company of the State of Pennsylvania - NAIC #19429 XWC 0910717 Nat'l Union Fire Ins Co - NAIC #19445 qualified States Covered CA AK, AL, AR, AZ, CO, CT, DC, DE, GA, HI, IA, ID, IL, IN, KS KY, LA, MD, MI, MN, MO, MS, MT, NC, NE, NH, NJ, NM, NV, NY, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WV MA, WI (ND, OH, WA, WI, WY - Covered for Stop -Gap EL only) FL ME OH, Ohio Qualified Self Insured (QSI) - SIR: $500,000; Only applicable to specific entities self -insured in the state of Ohio Waiver of Subrogation is applicable where required by written contract with respect to WC. If the insurer for the Workers Compensation policy cancels its policy for any reason other than for non-payment of premium, the insurer will provide 30 days notice of cancellation to those Certificate Holders that require it by written contract. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD